The nation’s workers may be struggling, but American companies just had their best quarter ever.
American businesses earned profits at an annual rate of $1.659 trillion in the third quarter, according to a Commerce Department report released Tuesday. That is the highest figure recorded since the government began keeping track over 60 years ago, at least in nominal or noninflation-adjusted terms.
Once every three or four months my son, Sam, grabs a cookie or a piece of candy and, wide-eyed, holds it inches from his mouth, ready to devour it. He knows he’s not allowed to eat these things, but like any 9-year-old, he hopes that somehow, this once, my wife, Evelyn, or I will make an exception.
FAMILY CIRCLE Sam’s twin sister, Beatrice, also has epilepsy.
Breakfast, lunch, dinner and snack: ingredients for a typical meal for Sam Vogelstein.
We never make exceptions when it comes to Sam and food, though, which means that when temptation takes hold of Sam and he is denied, things can get pretty hairy. Confronted with a gingerbread house at a friend’s party last December, he went scorched earth, grabbing parts of the structure and smashing it to bits. Reason rarely works. Usually one of us has to pry the food out of his hands. Sometimes he ends up in tears.
It’s not just cookies and candy that we forbid Sam to eat. Cake, ice cream, pizza, tortilla chips and soda aren’t allowed, either. Macaroni and cheese used to be his favorite food, but he told Evelyn the other day that he couldn’t remember what it tastes like anymore. At Halloween we let him collect candy, but he trades it in for a present. At birthday parties and play dates, he brings a lunchbox to eat from.
There is no crusade against unhealthful food in our house. Some might argue that unhealthful food is all we let Sam eat. His breakfast eggs are mixed with heavy cream and served with bacon. A typical lunch is full-fat Greek yogurt mixed with coconut oil. Dinner is hot dogs, bacon, macadamia nuts and cheese. We figure that in an average week, Sam consumes a quart and a third of heavy cream, nearly a stick and a half of butter, 13 teaspoons of coconut oil, 20 slices of bacon and 9 eggs. Sam’s diet is just shy of 90 percent fat. That is twice the fat content of a McDonald’s Happy Meal and about 25 percent more than the most fat-laden phase of the Atkins diet. It puts Sam at risk of developing kidney stones if he doesn’t drink enough. It is constipating, so he has to take daily stool softeners. And it lacks so many essential nutrients that if Sam didn’t take a multivitamin and a calcium-magnesium supplement every day, his growth would be stunted, his hair and teeth would fall out and his bones would become as brittle as an 80-year-old’s.
Evelyn, Sam’s twin sister Beatrice and I don’t eat this way. But Sam has epilepsy, and the food he eats is controlling most of his seizures (he used to have as many as 130 a day). The diet, which drastically reduces the amount of carbohydrates he takes in, tricks his body into a starvation state in which it burns fat, and not carbs, for fuel. Remarkably, and for reasons that are still unclear, this process — called ketosis — has an antiepileptic effect. He has been eating this way for almost two years.
Curiosity bordering on alarm is the only way to describe how people receive this information. “In-teresting,” one acquaintance said. “Did you make this up yourself?” Another friend was more direct: “Is this a mainstream-science thing or more of a fringe treatment?” We are not surprised by these reactions. What we are doing to Sam just seems wrong. The bad eating habits of Americans, especially those of children, are a national health crisis. Yet we are intentionally feeding our son fatty food and little else.
But what we are doing is mainstream science. Elizabeth Thiele, the doctor who prescribed and oversees Sam’s diet, is the head of the pediatric epilepsy program at Massachusetts General Hospital for Children, which is affiliated with Harvard Medical School. In fact, the regimen, known as the ketogenic diet, is now offered at more than 100 hospitals in the United States, Canada and other countries. We’re not opposed to drugs; we tried many. But Sam’s seizures were drug-resistant, and keto, the universal shorthand, often provides seizure control when drugs do not.
The idea of food as medicine has been a controversial topic in this country in recent years. For decades the fight that the late Robert Atkins and his low-carb acolytes had with mainstream medicine has been as vitriolic as a religious war. There are food cures for everything from cancer and heart disease to cataracts. Doctors talk about diet as a part of basic good health all the time. But talk to them about a diet instead of drugs to stop an infection or treat a tumor and most would be visibly alarmed, and in many cases, they would have good reason to be. A decade ago most doctors held the same contempt for keto. An Atkins-like diet that worked as well — and often better — than antiepileptic drugs? Common sense suggests that’s crazy.
But when it comes to keto’s impact on pediatric seizures, there is wide acceptance. There are about two dozen backward-looking analyses of patient data suggesting keto works, and, more significant, two randomized, controlled studies published in 2008. One of the trials, by researchers at University College London, found that 38 percent of patients on the diet had their seizure frequency reduced more than 50 percent and that 7 percent had their seizure frequency reduced more than 90 percent.
Those numbers may look low, but they’re not. These were patients for whom antiepileptic drugs had already failed. For children with certain kinds of drug-resistant seizures, Thiele’s clinical data show an even better response: 7 out of 10 were able to reduce their count more than 90 percent with the diet. Those statistics are as good as those for any antiepileptic drug ever made. Other pediatric neurologists get similar results. The diet has cut Sam’s seizures by 75 percent.
That is a big deal. There are dozens of antiepileptic drugs on the market, many approved in the last 15 years. The newer ones work with fewer side effects, and that’s important. But the percentage of patients who take drugs and still have seizures hasn’t changed meaningfully in decades. About a third of the nearly 3 million epileptics in the United States have drug-resistant seizures, and doctors estimate that at least 250,000 of those drug-resistant patients are children. Since keto often works when drugs do not, neurologists finally see a way to fix that problem.
There has been so much buzz around keto that neurologists and scientists have begun wondering what else it can do. Could it be used to treat seizures in adults? What about Parkinson’s, Alzheimer’s, A.L.S. and certain cancers? Tumors typically need glucose to grow. There is very little of this simple sugar in a keto diet, and there have been interesting results with mice that suggest the diet might slow tumor growth. These scientific explorations are in their early stages and may not amount to much. Nonetheless, researchers are taking them seriously.
Food as part of disease treatment is slowly being accepted by more doctors. Many think it is new. But it is not. During the first half of the 20th century, the impact of food on our bodies was one of the hottest scientific fields. Insulin was discovered in 1921, and its commercial production meant survival for diabetics. In the 1930s, three scientists won a Nobel Prize for discovering that a substance in raw liver cured pernicious anemia, a disease that was almost always fatal. Eight Nobels were awarded just for work related to vitamins. And, it turns out, the ketogenic diet was developed back in the early part of the last century, too, only to disappear from medical literature for two generations.
Our family’s introduction to keto came in February 2009, when we flew to Boston to see Thiele and Heidi Pfeifer, a dietitian who works with her, at Mass General. Joseph Sullivan, our neurologist at the University of California, San Francisco, told us that Thiele and Pfeifer were doing cutting-edge work. And we needed cutting-edge help. We tried 11 seizure drugs, and Sam was hospitalized twice during the previous year. Yet we were still struggling to keep Sam’s seizure count below 10 per hour. Every day, seven days a week, during the 13 hours he was awake, he would have between 100 and 130 seizures.
Nothing did any good. Some drugs, because of the side effects, actually did him harm. One drug gave him hand tremors, another made him a zombie and a third made him hallucinate, thinking that bugs and worms were crawling out of his skin.
I hit my low point the night we took Sam home from his second hospitalization in six months. He had been seizing almost nonstop for more than a week despite being on four medications. So after keeping him home from school for a week and having daily conversations with Sullivan, we decided to admit him for what Sullivan called a “reset.” The thinking is that, like a computer, doctors can reboot a person’s brain to reduce or stop seizures. They knocked Sam out with Ativan for 15 hours and monitored his brain waves. The following day he was discharged, seizing just as frequently, and, for his bravery, sporting a head-to-toe body rash from a reaction to a medication.
The best way to think about a seizure is to imagine an electrical storm. Our brains and bodies are normally full of electricity. The brain generates biochemical electrical charges, allowing brain cells, nerves and muscles to communicate. A seizure happens when this electricity surges out of control and overloads parts of the brain’s circuitry.
Sam doesn’t have grand mal seizures — the kind you see in movies — but a form of what’s known as petit mal, or absence seizures. Instead of falling down and twitching for minutes, Sam loses consciousness for short 5-to-20-second bursts. Grand mal and many other seizure types — there are dozens — often leave the sufferer exhausted. Sam’s seizures are more like hitting the pause button on a DVD. He stops and stares vacantly. His jaw slackens. And his head and torso lean forward slightly, bobbing rhythmically. Then it’s over, as if it had never happened. He is not disoriented, tired or in pain. If he was in the middle of a sentence, he would finish it. If he was going hand-over-hand on the monkey bars, he would pause without falling. It is not like a faint, when you go limp. Part of his brain has momentarily shut down. Though Sam says that he is sometimes aware when he is having a seizure, typically his only clue is that when he comes to, everything around him has shifted slightly. A lot more happens in 10 seconds than we think.
His seizures didn’t start this way. Epilepsy was first diagnosed in 2005, when Sam was just shy of 5. The diagnosis then was myoclonic epilepsy. Each day he would have about half a dozen spells that looked as if he had been touched by a cattle prod. Each was a strong, 45-degree snap forward at the waist. After a few tries, we found a medication that controlled them.
The absence seizures started at the end of 2007. We tried first to treat them by increasing the dose of the seizure drug he was already on. But by the end of March 2008 he was having more, not fewer, seizures, and by early fall he was having trouble finishing a sentence. His teachers watched out for him and told the class about what was going on. But it’s hard to learn math or reading when you’re receiving life on the other end of a bad cell-phone connection.
Swimming? Bike riding? Soccer team? Forget it. Sam couldn’t even cry without interruption: he would stub a toe or skin a knee; cry for 15 seconds; have a 15-second seizure; and then continue sobbing. Sam had trouble even watching a movie. Once after seeing “Speed Racer” at home, he said: “Dad, I think the DVD is scratched. When I was watching, it kept leaving words out.”
We were desperate, and frankly, despite advances, the ketogenic diet is still only for the desperate. For Sam’s diet to be effective, he must eat a certain number of calories every day with specific ratios of fat, protein and carbohydrates. These are not back-of-the-envelope calculations, but ratios that have to be hit exactly at every meal. If Sam wants a snack after school, he gets 18 grams of bacon (about two slices), 14 grams of macadamia nuts (about seven nuts) and 18 grams of apple (less than an eighth). In keto-speak that’s 3.04 grams of fat to every gram of protein and carbs combined. A snack using the ratios of the typical American diet — about 30 percent fat, 15 percent protein, 55 percent carbs — would have twice the protein, a third the fat and eight times the carbs.
To jump through these arithmetic hoops, Evelyn, who gave up her career to take on the now full-time job of feeding Sam, plans meals on the kitchen computer using a Web-based program called KetoCalculator. It is hard to imagine how to administer keto without it. A meal for Sam might have eight ingredients. Mathematically, there are potentially millions of combinations — a bit more of this; a bit less of that — that gets you to a 400-calorie meal and a 3-to-1 ratio. KetoCalculator does the math. Every ingredient — butter, cream, bacon, oil, eggs, nuts and fruit — is weighed to the 10th of a gram on an electronic jeweler’s scale. When Evelyn comes up with a recipe that works, she hits “print” and files it in a black loose-leaf binder. We now have more than 200 recipes.
Doing all this once is fascinating. Who knew that a cup of milk had more carbs than half a slice of toast or that macadamia nuts have more than twice the fat of pork rinds? But administering the diet for three meals and two snacks a day, seven days a week for two years is relentless. There is no “Let’s just order pizza” in our house, no matter how crazy the week has been. A barbecue at a friend’s house takes Evelyn 30 minutes of prep time. A sleepover takes two hours, because she labels all the food and writes out heating and serving instructions for the parents. Evelyn spent six hours preparing food for a three-day camping trip in August. Unexpected events that barely register in most families — like the fact that I recently ate the applesauce that was to be part of Sam’s breakfast — create mad scrambles to recalculate and reweigh meals so Sam gets out the door on time.
The diet is administered like medicine, and parents need to work with their neurologist and a keto dietitian to come up with an appropriate caloric intake for the child. You receive a log-in to KetoCalculator, which is only available through a clinician. Every three months, Sam’s height and weight are measured, and a baseline blood test is administered. This medical oversight lessens the worry that we are going to poison Sam with all the fat he eats. Children can fall into ketoacidosis — essentially overdoing keto. It’s rare, and easily reversible, but it can be fatal if you don’t know what to look for.
Ultimately what makes the diet so stressful is that on top of all the gross recipes and weird mechanics, there is no margin for error. Just as you can’t take blood-pressure medicine sporadically or vary its dose day to day, on keto you can’t just dump beaten eggs into a pan; you have to take a rubber spatula and scrape out the two or three grams that typically adhere to the measuring bowl. Then Sam needs to finish every bite of every meal. (Two other, somewhat less restrictive diets are also being prescribed for epileptic children, but neither worked as well for Sam.) The penalty for cheating, at least in Sam’s case, is seizures. During the first few weeks on the diet, a friend in his carpool shared a piece of toast. We lost seizure control for a week. Miraculously, Sam has done this only once.
Will the diet doom Sam to a lifetime of heart disease and high cholesterol? Thiele and Pfeifer don’t think so. There is research, published this year, suggesting that there are few lingering effects in the years after stopping the diet. Johns Hopkins Children’s Hospital in Baltimore, where the diet was pioneered in the 1920s, surveyed 101 former patients, most of whom had been off the diet for more than six years, and found that they had normal cholesterol and cardiovascular levels, no preference for fatty foods and, for those off the diet the longest, normal growth rates.
Certainly Sam’s appearance shows no sign that he is eating so much fat. There are reports that the diet can stunt children’s growth even if they are on vitamin supplements. But Sam started the diet when he was 4 feet 3 inches tall and weighed 51 pounds. He is now 4 feet 8 inches tall and 68 pounds. His cholesterol and related measures of fat in the bloodstream are elevated, as is typical for children on the diet. But the other tests are normal.
We don’t know how long Sam will be on this diet. It won’t be forever. Most who respond stay on it for about two years — which for Sam would be in April. But there is no magic number. I’ve read about some children who started in infancy and were on the diet for more than five years. Typically the diet is stopped at one of three junctures: when children have been seizure-free for two years; when they outgrow their seizures, as about 60 percent do; or when families decide the sacrifices required to stay on the diet have become too onerous.
If you want to see someone who has been on the ketogenic diet, look up Charlie Abrahams on YouTube. The video to look for is his speech to some 300 doctors, dietitians and researchers at the International Symposium on Dietary Therapy for Epilepsy and Other Neurological Disorders. When Charlie was a baby, his doctors diagnosed Lennox-Gastaut Syndrome, a particularly severe form of epilepsy that if not properly treated often leaves sufferers permanently brain damaged.
Drugs did nothing, and so, like many parents of children with serious illnesses, his parents, Jim and Nancy, became experts themselves. Jim, a Hollywood director and producer, read about the diet in an epilepsy book and called the author, Dr. John Freeman, at Johns Hopkins Medical Institution. In 1993 Freeman was the only doctor in the country using the diet consistently. He had been using it since 1969 and claimed that 30 percent of his patients were seizure-free. The idea seemed ridiculous to Charlie’s neurologist and most of the medical community at the time. The only thing you could stop with that much fat was your heart. “Flip a coin — I don’t think either will work,” his son’s neurologist said when Abrahams asked about trying keto or an herbal remedy he had also read about.
With nothing to lose, the Abrahamses put their son on the diet just after Thanksgiving in 1993. Three days later his seizures stopped. He was on the diet for four years and hasn’t had another seizure since. Today, at 18, Charlie is getting ready to graduate from high school.
The diet effectively cured a very sick child, but it only made an impact because Jim Abrahams made sure the rest of the world heard about it. He filmed a video about his experience starring his friend, Meryl Streep. “Dateline NBC” did a segment on Charlie in 1994, which led to an avalanche of media interest and letters from patients. At the same time, Abrahams started the Charlie Foundation to Help Cure Pediatric Epilepsy, an organization whose sole mission is to enable the diet to be administered in every hospital worldwide.
All this publicity led patients to ask their doctors about the diet; doctors started experimenting with it and recording their results; and as e-mail and Internet databases became widely available, word spread at an accelerating rate. In 1997, 15 hospitals were offering keto to epileptic children; now roughly 150 do, Abrahams says.
What astonished Abrahams and helped drive his effort to publicize the diet was that keto was not a new idea. It was first used as a medical treatment for epilepsy in the 1920s. The principles underlying the diet have been around since Hippocrates touched on them nearly 2,500 years ago. Starvation had long been one approach to treating epilepsy. Deny the patient food for, say, a week and often their seizures went away. But there were obvious limits on how long starvation could be used as a treatment. In the 1920s, researchers at the Mayo Clinic, looking for a way to treat diabetics, figured out that it was not fasting per se that helped control seizures. Rather, they found that it was what the body did during an extended fast that helped control them. Deprived of food, the human body starts burning body fat as fuel, and it was that process of ketosis that somehow had the antiepileptic effect. Trick the body into thinking it was starving by taking away its primary fuel of carbohydrates and forcing it to subsist on an all-fat diet, and you could create that antiepileptic effect as long as necessary.
The diet was quickly adopted and widely used through the 1930s. And then, almost as fast as it had appeared, the keto diet disappeared. When Dilantin was first used as an antiepileptic drug in 1938, its success steered medical minds toward pharmaceutical solutions. A generation later, the diet had been all but forgotten. There was no scientific evidence that it worked, after all. More important, it was incredibly difficult to administer. Even in the 1990s, Millicent Kelly, Charlie Abrahams’s dietitian at Johns Hopkins, was planning menus with a calculator and a legal pad.
By 2000, more people were asking about keto, but most pediatric neurologists still would not prescribe it. That bias seemed ridiculous to J. Helen Cross, the principal investigator of the 2008 randomized keto trial at University College London. “I’d been dealing with complex epilepsy cases for 10 years, and it was quite clear to me that certain children did respond to the ketogenic diet,” Cross says. “But we in our institution — and I know we weren’t alone — were coming up against barriers to get the resources to do it. They’d say there’s no evidence it works. It’s a quack diet. There is no controlled data. So I wanted to prove that it did work once and for all, and do it in a way so that people couldn’t argue with it.”
It took five years to enroll and track enough patients to make the study credible and another two years to analyze the data and undergo the rigorous academic peer-review process. But since the study was published in 2008, it has answered doubts about keto’s clinical effectiveness.
Keto has now attracted attention from all corners of the neurological community. Two scientists at the National Institutes of Health are planning a study of its effectiveness in Parkinson’s patients. Papers published in the past two years suggest that keto may slow the growth of a brain tumor in mice. A biotechnology company named Accera is marketing a high-fat powder to Alzheimer’s patients that is supposed to reproduce the effects of ketosis, without the dietary restrictions of keto.
Still, there is one giant unanswered question: Why does keto work? Jong Rho, the head of pediatric neurology at the University of Calgary and the Alberta Children’s Hospital, theorizes that ketone bodies — the compounds made by the liver when the body burns fat for energy — protect brain cells from being damaged. Rho, who just received a $2 million, five-year grant from the National Institutes of Health to continue to investigate this theory, says experiments with epileptic mice suggest that extended time on the diet makes them more seizure-resistant.
Rho’s theory, however, only raises more questions. How would ketone bodies protect brain cells? Scientists don’t have a clue about how our cells react during ketosis. They don’t even know how much ketone bodies themselves matter. Until scientists understand the basic biological mechanisms, they can’t begin to embark on the long and costly process of drug development.
The success of the pediatric diet seems to have made it easier for keto scientists to get money for this basic research. “Before Helen’s study, we all had a clear sense that keto worked,” says Carl Stafstrom, the head of pediatric neurology at the University of Wisconsin, “but we couldn’t say in a grant proposal that the diet has been proven to be effective. Now we can.” There are recently financed studies, for example, exploring why the body resists ketosis and exploring compounds that might trigger the antiepileptic mechanism.
All of this still puts us a long way from anything remotely resembling a pill that would replace the keto diet. Being able to eat normally — or even close to normally — is critical to expanding the benefits of the ketogenic diet beyond the roughly 3,500 pediatric epilepsy patients currently on it. There are few adults who could adhere to a diet like the one Sam is on.
For now the main alternatives to keto are the Modified Atkins Diet (MAD), published by Johns Hopkins in 2003, and Thiele and Pfeifer’s Low Glycemic Index Treatment (L.G.I.T.), published in 2005. MAD is more restrictive than the Atkins diet that people use for weight loss, but nonetheless a bit easier to follow than keto because it allows more protein; L.G.I.T. is easier than keto because it allows more carbs and protein as long as the carbs are like strawberries — which affect blood sugar slowly — and not like bread, potatoes or candy, which make it spike. There are volumes of clinical data supporting the effectiveness of these diets, but not yet the kind of randomized, controlled study that show these diets work as well as keto, and keto is still most often prescribed. We started Sam on L.G.I.T., moved to MAD and are now at keto. For the moment it seems to work best for him.
Sam isn’t seizure-free yet, but he’s so close that you might think he was. From well over 100 seizures a day, Sam now typically has fewer than 6. Keto got us most of the way there, but not all the way. The diet cut his seizures to roughly 30 a day, and two drugs, added separately to make sure we were changing only one variable at a time, did the rest. Sam is finally a happy, healthy and independent kid.
He’s learning to skateboard and swim out of the shallow end. We’re about to teach him to ride a bike. In June he made me go on the 100-foot free-fall ride at an amusement park. He loved it. (I loved it less.) He and his friends Nick and Ethan spend almost every weekend searching for portals to other worlds. And he leaves people who meet him to wonder if he isn’t one of the bravest and most disciplined kids they have ever met.
The truth is that as much control as Evelyn and I think we exert over Sam’s life — especially what he eats — we both understand that the person who is truly in charge of his health is Sam. Most days he and his Batman lunchbox are out of the house from 7 in the morning until 4 in the afternoon. At lunch, at class birthdays — everywhere he goes, really — there is the temptation to quite reasonably say, “I would like to eat and drink like all the other kids.” But he doesn’t. Instead, on his own, he politely says: “I’m not supposed to eat that. It gives me seizures.”
That doesn’t mean he likes it. He hates the diet. For his 10th birthday in May, he wants to go off keto; and we are going to try to honor that request. Will he start to seize uncontrollably again? In March, we found out that Sam’s twin sister, Beatrice, had epilepsy, too. At the moment, it’s completely controlled with medication. Will she grow out of it like many children do? Will Sam? Like all parents in our situation, we hope so. But we don’t know. At least we can comfort ourselves with the idea that we are participating in a grand exploration of the link between metabolism and brain chemistry that over the years may find some answers. That, at least, takes away some of the bad taste of this lousy diet.
Fred Vogelstein, a contributing editor for Wired, is writing a book about the intersection of technology and media in Silicon Valley.
The corner of Wall Street and Broadway, showing the limestone facade of One Wall Street in the backg...
Friday, November 19th, 2010
Friends,
When someone talks about pushing you off a cliff, it’s just human nature to be curious about them. Who are these people, you wonder, and why would they want to do such a thing?
That’s what I was thinking when corporate whistleblower Wendell Potter revealed that, when “Sicko” was being released in 2007, the health insurance industry’s PR firm, APCO Worldwide, discussed their Plan B: “Pushing Michael Moore off a cliff.”
But after looking into it, it turns out, it’s nothing personal! APCO wants to push everyone off a cliff.
APCO was hatched in 1984 as a subsidiary of the Washington, D.C. law firm Arnold & Porter — best known for its years of representing the giant tobacco conglomerate Philip Morris. APCO set up fake “grassroots” organizations around the country to do the bidding of Big Tobacco. All of a sudden, “normal, everyday, in-no-way-employed-by-Philip Morris Americans” were popping up everywhere. And it turned out they were outraged — outraged! — by exactly the things APCO’s clients hated (such as, the government telling tobacco companies what to do). In particular, they were “furious” that regular people had the right to sue big corporations…you know, like Philip Morris. (For details, see the 2000 report “The CALA Files” (PDF) by my friends and colleagues Carl Deal and Joanne Doroshow.)
Right about now you may be wondering: how many Americans get pushed off a cliff by Big Tobacco every year? The answer is 443,000 Americans die every year due to smoking. That’s a big cliff.
With this success under their belts, APCO created “The Advancement of Sound Science Coalition.” TASSC, funded partly by Exxon, had a leading role in a planned campaign by the fossil fuel industry to create doubt about global warming. The problem for Big Oil speaking out against global warming, according to the campaign’s own leaked documents, was that the public could see the “vested interest” that oil companies had in opposing environmental laws. APCO’s job was to help conceal those oil company interests.
And boy, have they ever succeeded. Polls now show that, as the world gets hotter, Americans are getting less and less worried about it.
How big is this particular cliff? According to the World Health Organization, climate change contributes — right now — to the deaths of 150,000 people every year. By 2030 it may be double that. And after that…well, the sky is literally the limit! I don’t think it’s crazy to say APCO may rack up even bigger numbers here than they have with tobacco.
With this track record, you can see why, when the health insurance industry wanted to come after “Sicko,” they went straight to APCO. The “worst case,” as their leaked documents say, was that “Sicko evolves into a sustained populist movement.” That simply could not be allowed to happen. Something obviously had to be done.
As Wendell Potter explains, APCO ran their standard playbook, setting up something called “Health Care America.” Health Care America, according to Potter, “was received by mainstream reporters, including the New York Times, as a legitimate organization when it was nothing but a front group set up by APCO Worldwide. It was not anything approaching what it was reporting to be: a ‘grassroots organization.’ It was a sham group.”
Health Care America showed up online in 2007 (the year “Sicko” was released) and disappeared quickly by early 2008. You can still find their website archived here. As you’ll see, their “moderated forum” allowed normal, everyday, in-no-way-employed-by-the-insurance-industry Americans to speak out. For instance, here’s something Nicole felt very strongly about:
“Moore shouldn’t be allowed to call his film a ‘documentary.’ It should be called a political commercial. We need to fix our health care system, but we shouldn’t accept a Hollywood moviemaker’s political views as the starting point.”
Here’s what Wendell Potter revealed about the insurance industry’s media strategy:
“As we would do the media training, we would always have someone refer to him as ‘Hollywood entertainer’ or ‘Hollywood moviemaker Michael Moore.’ They don’t want you to think that it was a documentary that had some truth.”
Thanks for your perspective, “Nicole”!
Now, how big was THAT cliff? A pretty good size — according to a recent study, 45,000 Americans die every year because they don’t have health insurance.
And here we are in 2010. A lesser PR firm might be resting on its laurels at this point, content to sit back and watch hundreds of thousands of people continue to be pushed off the various cliffs they’ve built. But not APCO! Right now they’ve taken on their biggest challenge yet: leading a giant, multi-million dollar effort to help Wall Street “earn back the trust of the American people.”
We may never know the size of this particular cliff. But we can be sure it’s gigantic. According to the New York Times, one of the things Wall Street’s recession gave us is “the crippling of the government program that provides life-sustaining antiretroviral drugs to Americans with H.I.V. or AIDS who cannot afford them.” Internationally, organizations fighting AIDS and other diseases are “hugely afraid” of cutbacks in funding.
Of course, there are the 101 ways recessions kill quietly. For instance, children’s hospitals are seeing a sharp 55% rise in the abuse of babies by parents.
And that’s just the previous cliff. If APCO and its Wall Street co-conspirators lull us into turning our backs on them again, we can be sure the next cliff — the next crash — will be much bigger.
Anyway, this is all just a way for me to say to APCO: No hard feelings! My getting mad at you would be like a chicken who’s still happily pecking away getting mad at McDonald’s. Compared to the millions you’ve already turned into McNuggets, you’ve actually treated me much, much BETTER! Spying on my family, planting smears and lies about me, privately badgering movie critics to give the film a poor review, scaring Americans into believing they’d be committing a near-act of treason were they to go to the theater and see my movie — hey, ya done good, health insurance companies of America. And, most important, you stopped the nation from getting true universal health care. Good job!
There’s only one problem — I’m not one of those “liberals” you fund in Congress, the ones who fear your power.
I’m me. And that, sadly, is not good for you.
Yours in good health,
Michael Moore
MMFlint@aol.com
MichaelMoore.com
P.S. It seems to me that APCO’s discussion of pushing me off a cliff should legitimately be part of their Wikipedia page. And why not something about their role in Wall Street’s new PR offensive? So I’m asking everyone interested to write something up that meets Wikipedia’s guidelines and help bring the APCO Worldwide entry up to date. Post it somewhere online and send a tweet about it to @mmflint. I’ll award a signed copy of “Sicko” by noon Sunday to the best entry…and then deputize you to post it on Wikipedia for real and make sure APCO’s minions don’t take it down. Just be sure afterward not to walk near any cliffs!
P.P.S. The late, great comedian Bill Hicks had some thoughts about marketing and the people who do it.
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Official portrait of the Director of the Federal Bureau of Investigations Robert S. Mueller.
Now that most Americans rarely ever use landlines but are instead occupied on the web and with their smartphones, the FBI is trying to step up its surveillance game to keep up with the times — to the detriment of our civil liberties.
Last week, agency director Robert Mueller went to Sillicon Valley (much like Mark Zuckerberg in “The Social Network“) with a somewhat frightening proposal: Facebook and Google should build “back doors” into their systems to allow ease for spying.
But groups like the ACLU says these physical mechanisms could be exploited by everyone from hackers to autocratic regimes cracking down on dissent.
“It is important to realize that this proposal isn’t simply applying the same sort of wiretap system we have for phones to the Internet; it would require reconfiguring and changing the nature of the Internet,” said Laura Murphy of the ACLU in a statement.
“We remain very concerned that this proposal is a clear recipe for abuse and will make it that much easier for the government to gain access to our most personal information. Americans should not simply surrender their privacy and other fundamental values in the name of national security.”
Even within the Obama administration, there is some consternation that the changes sought by the FBI would inhibit innovation and aid repressive regimes.
Read more at The New York Times and Raw Story.
By Sarah Seltzer | Sourced from Alternet
Image via Wikipedia
Wednesday, November 17th, 2010
Friends,
Yesterday, on the TV and radio show “Democracy Now” hosted by Amy Goodman, the former Vice President of CIGNA, one of the nation’s largest health insurance companies, revealed that CIGNA met with the other big health insurers to hatch a plan to “push” yours truly “off a cliff.”
The interview contains new revelations about just how frightened the health industry was that “Sicko” might ignite a public wave of support for “socialized medicine.” So the large health insurance companies came together over a common cause: Stop the American people from going to see “Sicko” — and the way to do that was to cause some form of harm to me (either personally, professionally or…physically?).
Take a look at this stunning section of the interview with Wendell Potter:
WENDELL POTTER [former executive, CIGNA]: …We were concerned that the movie [“Sicko”] would be as successful as “Fahrenheit 9/11” had been. And we knew that if it were, it really would change public opinion about our health care system in ways that would be harmful to the profits of health insurers. So, it was very important for this [attack] campaign to succeed. At one point during a strategy meeting, one of the people from [the insurance companies’ public relations firm] APCO said that if our efforts, our initial efforts, were not successful, then we’d have to move to an element of the campaign to push Michael Moore off a cliff. And not meaning to do that literally, but to—
AMY GOODMAN: Are you sure?
WENDELL POTTER: Well, I’m not sure. To tell you the truth, when I started doing what I’m doing [as a whistleblower], I was concerned about my own health and well-being, maybe just from paranoia. But these companies play to win. And we’re talking about some big bucks at stake here—billions and billions and billions of dollars.
AMY GOODMAN: So what were they talking about when they said, “If this doesn’t work, we’re going to push him off the cliff”?
WENDELL POTTER: Well, it would be just an incredibly intense PR effort, if necessary, to spend more premium dollars to defame Michael Moore, to discredit him even more as a filmmaker.
AMY GOODMAN: So, were you doing research on him?
WENDELL POTTER: Oh, yeah. Oh, yeah.
AMY GOODMAN: You were going—personally?
WENDELL POTTER: Well, I was a part of the effort. I didn’t—that was part of the reason for hiring APCO and to work with a trade association, is that it relieved me of the responsibility of doing that kind of work. You paid for it to be done by people who were experts in doing that kind of research.
AMY GOODMAN: But they were doing an investigation into him personally?
WENDELL POTTER: Well, absolutely. We knew as much about him probably as he knows about himself.
AMY GOODMAN: About his wife, about his kid, about—
WENDELL POTTER: Oh, yeah. You know, it’s important to know everything that you might be able to use in some kind of a campaign against someone, to discredit them professionally and often personally.
AMY GOODMAN: And did you use that?
WENDELL POTTER: You use it if necessary.
The interview goes on as Potter reveals how his front group was able to get its talking points and smears into stories in the New York Times and CNN. It is a chilling look inside how easy it is to manipulate our mainstream media — and just how worried the health insurance companies were that the American people might demand a true universal health care system.
In particular, Potter talks about how they may have succeeded in influencing CNN to run a factually untrue story about “Sicko” by its reporter, Sanjay Gupta (which led to my infamous encounter with Wolf Blitzer and later, an apology from CNN for getting their facts wrong).
Potter believes his work to defame “Sicko” succeeded, as the film didn’t end up posting “Fahrenheit 9/11” grosses. To be clear, “Sicko” went on to become the 3rd largest grossing documentary of all time at that point. And as the release of “Sicko” in June of 2007 was the first time since the defeat of Hillary Clinton’s healthcare bill in 1994 that the issue of health insurance was brought to the forefront of the national media, I believe it helped to reignite the issue during the 2008 election year by exposing millions of Americans to the truth about the health insurance industry. More than one person on Capitol Hill will admit that “Sicko” was a big help in rallying public support for the compromise bill that eventually passed earlier this year. But I agree, their smear campaign was effective and did create the dent they were hoping for — single payer and the public option never even made it into the real discussion on the floor of Congress.
(There was really only one reason “Sicko” didn’t sell as many tickets as “Fahrenheit” and that was because of a felony that was committed — a felony that I will discuss for the first time on this site in the coming weeks or months ahead. Stay tuned.)
Please read or watch the entire interview with Wendell Potter. It’s a fascinating peek behind the curtain of how corporate America really runs this country. And how if any of us get in their way, then those people must be stopped. It begs the question: Seeing how there’s more of us than there are of them, how long will we let their takeover of our democracy continue?
God Bless the Ruling Class,
Michael Moore
MMFlint@aol.com
MichaelMoore.com
P.S. Over the next few days I will continue this examination of the Wendell Potter revelations on “Democracy Now” and in his new book. Please check in to my website.
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NASDAQ in Times Square, NY City, USA
The Fourteenth Banker writes:
In the stock market, program trading dominates volume. I heard recently that 70% of trade positions are held for an average of 11 seconds.
He’s correct.
As the New York Times dealbook noted in May:
These are short-term bets. Very short. The founder of Tradebot, in Kansas City, Mo., told students in 2008 that his firm typically held stocks for 11 seconds. Tradebot, one of the biggest high-frequency traders around, had not had a losing day in four years, he said
Similarly, FT’s Martin Wheatley pointed out last month:
I know of one HFT firm operated out of the west coast of the US that boasts its average holding period for US equities is 11 seconds
And market analyst Peter Cohan writes at AOL‘s Daily Finance:
70% of trading volume on the major exchanges is conducted by high-frequency traders who hold a stock for an average of 11 seconds.
The fact that the vast majority of stock market trades are held for 11 seconds shows that the stock market is not a real market with real traders governed by the law of supply and demand, and that there is no real price discovery.
But as Tyler Durden points out, a lot can happen in 11 seconds when the players are high-powered computers:
http://vidrebel.wordpress.com/
A honeybee on an apiary, cooling by flapping its wings. Location: Tübingen-Hagelloch.
Original Content at http://www.opednews.com/articles/The-Best-Science-Money-can-by-Katherine-Eban-101010-95.html
By Katherine Eban
Few ecological disasters have been as confounding as the massive and devastating die-off of the world’s honeybees. The phenomenon of Colony Collapse Disorder (CCD) — in which disoriented honeybees die far from their hives — has kept scientists, beekeepers, and regulators desperately seeking the cause. After all, the honeybee, nature’s ultimate utility player, pollinates a third of all the food we eat and contributes an estimated $15 billion in annual agriculture revenue to the U.S. economy.
The long list of possible suspects has included pests, viruses, fungi, and also pesticides, particularly so-called neonicotinoids, a class of neurotoxins that kills insects by attacking their nervous systems. For years, their leading manufacturer, Bayer Crop Science, a subsidiary of the German pharmaceutical giant Bayer AG (BAYRY), has tangled with regulators and fended off lawsuits from angry beekeepers who allege that the pesticides have disoriented and ultimately killed their bees. The company has countered that, when used correctly, the pesticides pose little risk.
A cheer must have gone up at Bayer on Thursday when a front-page New York Times article, under the headline “Scientists and Soldiers Solve a Bee Mystery,” described how a newly released study pinpoints a different cause for the die-off: “a fungus tag-teaming with a virus.” The study, written in collaboration with Army scientists at the Edgewood Chemical Biological Center outside Baltimore, analyzed the proteins of afflicted bees using a new Army software system. The Bayer pesticides, however, go unmentioned.
What the Times article did not explore — nor did the study disclose — was the relationship between the study’s lead author, Montana bee researcher Dr. Jerry Bromenshenk, and Bayer Crop Science. In recent years Bromenshenk has received a significant research grant from Bayer to study bee pollination. Indeed, before receiving the Bayer funding, Bromenshenk was lined up on the opposite side: He had signed on to serve as an expert witness for beekeepers who brought a class-action lawsuit against Bayer in 2003. He then dropped out and received the grant.
Reporter: scientist “did not volunteer” funding sources
Bromenshenk’s company, Bee Alert Technology, which is developing hand-held acoustic scanners that use sound to detect various bee ailments, will profit more from a finding that disease, and not pesticides, is harming bees. Two years ago Bromenshenk acknowledged as much to me when I was reporting on the possible neonicotinoid/CCD connection for Conde Nast Portfolio magazine, which folded before I completed my reporting.
Bromenshenk defends the study and emphasized that it did not examine the impact of pesticides. “It wasn’t on the table because others are funded to do that,” he says, noting that no Bayer funds were used on the new study. Bromenshenk vociferously denies that receiving funding from Bayer (to study bee pollination of onions) had anything to do with his decision to withdraw from the plaintiff’s side in the litigation against Bayer. “We got no money from Bayer,” he says. “We did no work for Bayer; Bayer was sending us warning letters by lawyers.”
A Bayer publicist reached last night said she was not authorized to comment on the topic but was trying to reach an official company spokesperson.
The Times reporter who authored the recent article, Kirk Johnson, responded in an e-mail that Dr. Bromenshenk “did not volunteer his funding sources.” Johnson’s e-mail notes that he found the peer-reviewed scientific paper cautious and that he “tried to convey that caution in my story.” Adds Johnson: The study “doesn’t say pesticides aren’t a cause of the underlying vulnerability that the virus-fungus combo then exploits….”
At least one scientist questions the new study. Dr. James Frazier, professor of entomology at Penn State University, who is currently researching the sublethal impact of pesticides on bees, said that while Bromenshenk’s study generated some useful data, Bromenshenk has a conflict of interest as CEO of a company developing scanners to diagnose bee diseases. “He could benefit financially from that if this thing gets popularized,” Frazier says, “so it’s a difficult situation to deal with.” He adds that his own research has shown that pesticides affect bees “absolutely, in multiple ways.”
Underlying cause of bee deaths still unclear
Dr. Jennifer Sass, a senior scientist with the health group at the Natural Resources Defense Council, says that while the Bromenshenk/Army study is interesting, it fails to ask the underlying question “Why are colonies dying? Is it because they’re getting weak? People who have HIV don’t die of HIV. They die of other diseases they get because their immune systems are knocked off, making them more susceptible.” In other words, pesticides could weaken the bees — and then the virus/fungus combination finishes them off. That notion, however, is not explored in the new study.
In 2008 the NRDC sued the Environmental Protection Agency after it failed to release Bayer’s underlying studies on the safety of its neonicotinoids. The federal agency has since changed course, and NRDC researchers are being allowed to sift through the Bayer studies, an NRDC spokesman says.
The EPA has based its approval of neonicotinoids on the fact that the amounts found in pollen and nectar were low enough to not be lethal to the bees — the only metric they have to measure whether to approve a pesticide or not. But studies have shown that at low doses, the neonicotinoids have sublethal effects that impair bees’ learning and memory. The USDA’s chief researcher, Jeff Pettis, told me in 2008 that pesticides were definitely “on the list” as a primary stressor that could make bees more vulnerable to other factors, like pests and bacteria.
In 1999, France banned Imidacloprid after the death of a third of its honeybees. A subsequent report prepared for the French agricultural ministry found that even tiny sublethal amounts could disorient bees, diminish their foraging activities, and thus endanger the entire colony. Other countries, including Italy, have banned certain neonicotinoids.
Bayer v. beekeepers
As for the Bayer-Bromenshenk connection, in 2003 a group of 13 North Dakota beekeepers brought a class-action lawsuit against Bayer, alleging that the company’s neonicotinoid, Imidacloprid, which had been used in nearby fields, was responsible for the loss of more than 60% of their hives. “My bees were getting drunk,” Chris Charles, a beekeeper in Carrington, N.D., and a plaintiff in the lawsuit, told me in 2008. “They couldn’t walk a white line anymore — they just hung around outside the hive. They couldn’t work.”
Charles and the other North Dakota beekeepers hired Bromenshenk as an expert witness. Bayer did not dispute that Imidacloprid was found among the bees and their hives. The company simply argued that the amount had not been enough to kill them.
As the North Dakota lawsuit moved forward, an expert witness for the beekeepers, Dr. Daniel Mayer, a now retired bee expert from Washington State University, traveled to 17 different bee yards in North Dakota and observed dead bees and bees in the throes of what looked like Imidacloprid poisoning, he told me in 2008. He theorized that after foraging in planted fields where the seeds had been treated with Imidacloprid, the bees then brought the pesticide back to the hive, where it built up in the wax combs.
The beekeepers tried to enlist more expert witnesses, but others declined, according to two of the beekeeper plaintiffs, in large part because they had taken research money from Bayer and did not want to testify against the company. One who agreed — Bromenshenk — subsequently backed out and got a research grant from Bayer. Bromenshenk insists the two actions were unrelated. “It was a personal decision,” he says. “I, in good conscience, couldn’t charge beekeepers for services when I couldn’t help them.” He adds, “Eventually, the lawyers stopped calling. I didn’t quit. They just stopped calling.”
In June 2008 a district court judge in Pennsylvania defanged the beekeepers’ lawsuit by siding with Bayer to exclude Mayer’s testimony and the initial test results from a laboratory in Jacksonville, Fla., that had found significant amounts of Imidacloprid in the honeybee samples.
That same year Bromenshenk brokered a meeting between Bayer and beekeepers. When I interviewed Bromenshenk that year, he said that increasing frustration with the accusations against Bayer, which he described as a “runaway train,” led him to contact the company in an effort to create a dialogue between Bayer and the beekeepers. Because of his efforts, in November 2008, Bayer scientists sat down in Lake Tahoe, Nev., with a small group of American beekeepers to establish a dialogue. The issues discussed were “trust and transparency,” Bromenshenk told me. “How did Bayer do its testing, and do we trust the results?” Generally beekeepers and scientists have been highly critical of the design of Bayer’s studies and deeply suspicious over who is or isn’t on Bayer’s payroll.
After the meeting, Bayer tentatively agreed to appoint a beekeeper advisory board to help redesign studies so that beekeepers could trust the results. But many beekeepers see the advisory board and grant money as a ruse on Bayer’s part to silence its enemies by holding them close. “They have the bee industry so un-united,” says Jim Doan, once New York State’s busiest beekeeper until CCD decimated his business. “Even the researchers are off working on anything but the pesticide issue.”
Bromenshenk’s study acknowledges that the research does not “clearly define” whether the concurrent virus and fungus, which were found in all the afflicted bee samples, is “a marker, a cause, or a consequence of CCD.” It also notes uncertainty as to how, exactly, the combination kills the bees, and whether other factors like weather and bee digestion play a role. Scientists like Sass at NRDC believe the mystery is far from resolved: “We’re even concerned that based on this, beekeepers will use more pesticides trying to treat these viruses,” says Sass.
Margot B News
Ninette
Margot B. News 
Michael Moore: Why Republicans Are Always Worried About Their Pet Corporations Facing Any Real Free Market Competition
Cover of Fahrenheit 9/11
By Michael Moore, MichaelMoore.com
Posted on October 21, 2010, Printed on October 21, 2010
http://www.alternet.org/story/148567/
I have a rule of thumb that’s served me well my whole life: whenever corporate executives begin talking about how they support “free markets” and “competition,” check to see if you still have your wallet.
That’s because no one — not Karl Marx, not Fidel Castro, not your niece who owns the only lemonade stand on the block — hates competition more than corporations. The whole goal of a corporation is to crush all the competition. When corporate executives start pushing for “free market policies,” what they mean is a government that lets them become a monopoly.
Don’t believe me? Well, count how many corporate CEOs (and Republican politicians) stand up and cheer for the Obama administration this week:
The Justice Department sued Blue Cross Blue Shield of Michigan on Monday, asserting that the company, the state’s dominant health insurer, had violated antitrust laws and secured a huge competitive advantage by forcing hospitals to charge higher prices to Blue Cross’s rivals.
The civil case appears to have broad implications because many local insurance markets, like those in Michigan, are highly concentrated, and Blue Cross and Blue Shield plans often have the largest shares of those markets. […]
Blue Cross and Blue Shield, like most insurers, contracts with hospitals, doctors, labs and other providers for services. The lawsuit took direct aim at contract clauses stipulating that no insurance companies could obtain better rates from the providers than Blue Cross. Some of these contract provisions, known as “most favored nation” clauses, require hospitals to charge other insurers a specified percentage more than they charge Blue Cross — in some cases, 30 to 40 percent more, the lawsuit said.
As the New York Times reports, Blue Cross Blue Shield insures 60% of Michiganders — including me and everyone in my office. They have nine times more customers than the state’s next largest insurer.
And they’re just doing what businesses do, even non-profits like Blue Shield: use all their power to eliminate the competition. In fact, if Daniel J. Loepp, Blue Cross’s CEO, didn’t do that, he’d be kicked out and someone who did would replace him. (I’d hate to see that happen — he always seems like a real gentlemen when he writes every year to tell us they’re hiking our premiums 27%.)
So this is the future we face with health care in the U.S., even with Obama’s new bill: endless battles between the federal government and health insurance corporations as the companies use all their ingenuity to give us fewer choices and higher prices…at least until we get President Palin, who’ll stop fighting the biggest insurance companies and start helping them kill their competition. Which she’ll do while giving tons of speeches about the need for competition and free markets.
Is there any solution for Michigan? Yes, and it’s just across the river in Canada: they have single-payer health insurance. Of course, at this point we pretty much do too. The difference is that our single-payer is run by a corporation. Theirs is run by the government — or to put it another way, democratically.
P.S. Blue Cross Blue Shield is fantastic at making secret agreements with hospitals, but not so great at actually getting people health care: the U.S. is now ranked 49th worldwide in life expectancy. Look out, French Polynesia, we’re coming for you next!
Michael Moore is an Academy Award-winning filmmaker and author. He directed and produced Roger & Me, Bowling for Columbine, Fahrenheit 9/11, and Sicko. He has also written seven books, most recently, Mike’s Election Guide 2008
© 2010 MichaelMoore.com All rights reserved.
View this story online at: http://www.alternet.org/story/148567/
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